CMS Price Transparency Data

Breast lump removal

Facility: Deaconess Illinois Crossroads

Billing Code: 19120 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 19120
Insurance Median: $792
Cash Discount Price: $663
vs. Medicare Baseline: 0.20x Medicare

The contracted insurance negotiated median rate for a Breast lump removal at Deaconess Illinois Crossroads is $792. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $663. Compared to the federal Medicare reimbursement reference rate of $4,000.24, this hospital’s rate is 0.20x the Medicare baseline. Located in 8 Doctors Park Rd, Mount Vernon, IL.

Cash / Self-Pay

$663

Average discount available for prompt cash payment at this facility.

Insurance Median

$792

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$4,000.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4,000.24 (100%)

Cash / Self-Pay: $663 (17%)

Insurance Median: $792 (20%)

Cash: $663 (17% of Medicare)

Ins. Median: $792 (20% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4,000.24 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$292 - $4,072	7%
Blue Cross Blue Shield	$292 - $3,992	7%
Meridian Health Plan	$292 - $3,992	7%
Molina Healthcare Of Illinois	$292 - $4,032	7%
Wellcare	$292 - $3,992	7%
Humana	$410 - $3,992	10%
Mytru Advantage	$410 - $3,992	10%
Umwa	$410 - $3,992	10%
UnitedHealthcare	$410 - $3,992	10%
Healthlink	$478 - $499	12%
Alliance Coal	$566 - $6,586	14%
Alter-Net Medical Services, Inc.	$656 - $11,376	16%
Noncontracted	$656 - $6,387	16%
Self-Pay	$663	17%
Cigna	$737	18%
Deaconess Onecare	$841	21%
Prime Health Services	$1,421	36%
Guardian Resources, Inc.	$1,592	40%
Healthcare'S Finest Network (Hfn)	$1,611	40%
Medicalcontrol Network Solutions	$1,611	40%
National Provider Network	$1,611	40%
Three Rivers Provider Network	$1,649	41%
Beech Street	$1,668	42%
Care Improvement Plus	$4,072	102%
Hope Trust	$11,376	284%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $663.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 19120.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Deaconess Illinois Crossroads is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 19120.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.